Emergency Department Downtime Case Study

 PLEASE MAKE SURE YOU ALSO DO THE FORM TO CAPURE DATA WHEN THE EMERGENCY DEPARTMENT REGISTRATION SYSTEM IS NOT AVAILABLE

Prior to beginning work on this assignment, read Chapter 20 in Health Informatics: An Interprofessional Approach.

Read the Emergency Department Downtime case study found at the end of Chapter 20 in Health Informatics: An Interprofessional Approach. Answer the questions posed in the course textbook. In addition, design a form for capturing data when the Emergency Department registration system is not available.

For this assignment, you will be using Microsoft Word drawing functions in order to construct the data form. If you need assistance with using Microsoft products, you can review Microsoft’s

Office Help & Training (Links to an external site.)

web page.

Your case study must include

• A minimum of 20 data elements which comprise a data dictionary outlining the following fields for each data element:

  Data field name
  Field format (alpha, numeric or alpha numeric)
  Number of characters in the field
  Source of information
  Example of the content

• A memorandum to the end users written as though you were the IT Department in the case.
• A picture that plots the downtime components discussed in the case:

  Time of day/number of users
  IT infrastructure affected
  System criticality
  Planned versus unplanned
  Health system complexity
  Communication: Amount required and are communication methods affected?
  Ability to recover

The Case Study Paper

• Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.)’s APA Style (Links to an external site.)
• Must include a separate title page with the following:

  Title of paper including the chapter number and case study title
  Student’s name
  Course name and number
  Instructor’s name
  Date submitted

• For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).
• Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
• Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.

  For assistance on writing Introductions & Conclusions (Links to an external site.) as well as Writing a Thesis Statement (Links to an external site.), refer to the Ashford Writing Center resources.

• Must use at least two scholarly or credible sources in addition to the course text.

  The Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
  To assist you in completing the research required for this assignment, view this Ashford University Library Quick ‘n’ Dirty (Links to an external site.) tutorial, which introduces the Ashford University Library and the research process, and provides some library search tips.

• Must document any information used from sources in APA style as outlined in the Ashford Writing Center’s Citing Within Your Paper (Links to an external site.)
• Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center. See the Formatting Your References List (Links to an external site.) resource in the Ashford Writing Center for specifications.

Carefully review the

Grading Rubric (Links to an external site.)

for the criteria that will be used to evaluate your assignment.

12. Office of the Assistant Secretary for Preparedness and Response
Hospital Preparedness Program. National Guidance for
Healthcare System Preparedness; 2012. http://www.phe.gov/
Preparedness/planning/hpp/reports/Documents/capabilities .

13. Office of the Assistant Secretary for Preparedness and Response
Hospital Preparedness Program. Hospital Preparedness Program
Overview; 2014. http://www.phe.gov/Preparedness/planning/
hpp/Pages/overview.aspx.

14. Morse S. California Hospitals Prepared as Wildfires Rage,
Association Says; 2015. http://www.healthcarefinancenews.com/
news/california-hospitals-prepared-wildfires-rage-association-says.

15. Ash JS, Sittig DF, Poon EG, Guappone K, Campbell E,
Dykstra RH. The extent and importance of unintended
consequences related to computerized provider order entry.
J Am Med Inform Assoc. 2007;14(4):415–423.

16. Nelson N. Downtime procedures for a clinical information
system: a critical issue. J Crit Care. 2007;22:45–50.

17. University of Texas Health Science Center at Houston. Emergency
Management Plan; 2015. https://www.uthealthemergency.org/
UTHealth-Emergency-Management-Plan .

18. Fahrenholz CG, Smith LJ, Tucker K, Warner D. A Practical
Approach to Downtime Planning in Medical Practices. American
Health Information Management Association; 2009. http://
library.ahima.org/xpedio/groups/public/documents/ahima/
bok1_045486.hcsp?dDocN.

19. Williams College: Office of Information Technology. Downtime
Policy. http://oit.williams.edu/policies/downtime/. Accessed
June 13, 2016.

20. Vaughn S. Planning for system downtimes. Comput Inform NU.
2011;29(4):201–203.

21. Arraj V. ITIL: the basics. Best Management Practice. White
Paper; 2010. http://www.best-management-practice.com/
gempdf/itil_the_basics .

22. Whitten J, Bentley L. System Analysis and Design Methods.
7th ed. McGraw-Hill Higher Education: New York, NY; 2007.

23. American Nurses Association. The Nursing Process. Nursing
World; 2012. http://nursingworld.org/EspeciallyForYou/What-
is-Nursing/Tools-You-Need/Thenursingprocess.html.

24. Hoerbst A, Hackl WO, Blomer R, Ammenwerth E. The status of
IT service management in health care: ITIL in selected European
countries. BMC Med Inform Decis Mak. 2011;11:76.

25. Hoong LL, Marthandan G. Factors influencing the success of the
disaster recovery planning process: a conceptual paper.
In: Research and Innovation in Information Systems (ICRIIS),
2011 International Conference; 2011:23–24. http://dx.doi.org/
10.1109/ICRIIS.2011.6125683.

26. Federal Emergency Management Agency (FEMA). IT Disaster
Recovery Plan; 2012. http://www.ready.gov/business/
implementation/IT.

27. Federal Emergency Management Agency (FEMA). Business
Continuity Plan; 2012. http://ready.gov/business/
implementation/continuity.

28. Nickolette C. Business Continuity Planning Description and
Framework. Comprehensive Consulting Solutions, Inc; 2001.
http://www.comp-soln.com/BCP_whitepaper .

29. Healthcare and Public Health Sector. Working without
technology: how hospitals and healthcare organizations can
manage communication failure. n.d. http://www.phe.gov/
Preparedness/planning/cip/Documents/
workingwithouttechnology . Accessed June 13, 2016.

30. (x)matters. Proactive Communications During Major Incidents.
Best Practices Beyond Incident Resolution (whitepaper); 2015.
http://www.xmatters.com/resource/proactive-communications-
during-major-incidents/.

DISCUSSION QUESTIONS

1. Explain the importance of an organization-specific down-
time risk assessment.

2. Describe the pros and cons of different assessment tools
for evaluating downtime events and discuss scenarios in
which they might be used to their best advantage.

3. Compare and contrast the roles of the informatician, the
clinician, and IT personnel in system downtime planning.

4. Describe key components of a business continuity plan
and (a) how they might differ for different types of orga-
nizations and (b) how they might differ depending on
EHR maturity level.

5. Contrast different communication methods for system
downtime events and summarize the pros and cons
of each.

CASE STUDY

At your Level 2 trauma center, an unplanned EHR downtime
occurs at 17:00 on a Tuesday. After 1 hour of troubleshooting
and working with the vendor’s help desk, the IT team
attempts a system reboot, which is unsuccessful. The vendor
is in a different time zone, so specialists have to be called in
from home to respond to this incident. The initial assessment
is that the downtime is due to database corruption and the
system will have to be recovered from backup systems. Unfor-
tunately, the system is not configured with high availability
techniques, nor is it redundant. The IT department estimates

that it will take 8 hours to recover the system, for a total down-
time of 10 hours.

Discussion Questions
1. Plot each component on the Downtime Determinator for

both part 1 and part 2 of the scenario as it unfolded, and
document your IT response, end user response, and
communication plans.

2. Make changes to the assessment and plans to account for
changes to the scenario.

351CHAPTER 20 Downtime and Disaster Recovery for Health Information Systems

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2020-09
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shayna
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2020-09
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shayna
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rd.edu
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2020-09
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shayna
.rocourt
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nt.ashfo
rd.edu
Person
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not repr
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2020-09
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shayna
.rocourt
@stude
nt.ashfo
rd.edu
Person
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not repr
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2020-09
-09
shayna
.rocourt
@stude
nt.ashfo
rd.edu

http://www.phe.gov/Preparedness/planning/hpp/reports/Documents/capabilities

http://www.phe.gov/Preparedness/planning/hpp/reports/Documents/capabilities

http://www.phe.gov/Preparedness/planning/hpp/Pages/overview.aspx

http://www.phe.gov/Preparedness/planning/hpp/Pages/overview.aspx

http://www.healthcarefinancenews.com/news/california-hospitals-prepared-wildfires-rage-association-says

http://www.healthcarefinancenews.com/news/california-hospitals-prepared-wildfires-rage-association-says

https://www.uthealthemergency.org/UTHealth-Emergency-Management-Plan

https://www.uthealthemergency.org/UTHealth-Emergency-Management-Plan

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_045486.hcsp?dDocN

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_045486.hcsp?dDocN

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_045486.hcsp?dDocN

Downtime Policy

http://www.best-management-practice.com/gempdf/itil_the_basics

http://www.best-management-practice.com/gempdf/itil_the_basics

http://nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html

http://nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html

http://dx.doi.org/10.1109/ICRIIS.2011.6125683

http://dx.doi.org/10.1109/ICRIIS.2011.6125683

http://www.ready.gov/business/implementation/IT

http://www.ready.gov/business/implementation/IT

http://ready.gov/business/implementation/continuity

http://ready.gov/business/implementation/continuity

http://www.comp-soln.com/BCP_whitepaper

http://www.phe.gov/Preparedness/planning/cip/Documents/workingwithouttechnology

http://www.phe.gov/Preparedness/planning/cip/Documents/workingwithouttechnology

http://www.phe.gov/Preparedness/planning/cip/Documents/workingwithouttechnology

http://www.xmatters.com/resource/proactive-communications-during-major-incidents/

http://www.xmatters.com/resource/proactive-communications-during-major-incidents/

https://platform.virdocs.com/rscontent/epub/582951/1629902/OEBPS/xhtml/page-381.xhtml?#spNone